Name of the Procedure:

Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area

Summary

An arthrotomy with synovectomy of the knee is a surgical procedure where the knee joint is opened to remove inflamed or diseased synovial tissue. This specific type involves accessing both the front (anterior) and back (posterior) regions of the knee, including the popliteal area behind the knee.

Purpose

This procedure targets conditions that cause inflammation or damage to the synovial membrane of the knee joint, such as rheumatoid arthritis or chronic synovitis. The goal is to relieve pain, reduce inflammation, and improve joint function.

Indications

• Persistent knee pain and swelling unresponsive to conservative treatments
• Reduced mobility due to inflamed synovial tissue
• Degenerative joint conditions causing significant impairment
• Diagnostic necessity to assess or confirm intra-articular pathology

Preparation

• Patients may need to fast for at least 8 hours prior to the procedure
• Medication adjustments, particularly blood thinners, may be necessary
• Pre-operative imaging tests such as X-rays or MRI
• Blood tests and a physical examination to assess overall health

Procedure Description

1. General or regional anesthesia is administered.
2. The surgeon makes incisions in both the anterior and posterior aspects of the knee.
3. The knee joint is opened surgically (arthrotomy).
4. Inflamed or diseased synovial tissue is identified and carefully removed (synovectomy).
5. The surgical site is inspected for any other issues, which are addressed if necessary.
6. The joint is irrigated to clear debris, and incisions are closed with sutures or staples.
7. A sterile dressing is applied to the site, and the knee is typically immobilized temporarily.

Tools and Equipment:

• Scalpel, surgical scissors, and forceps
• Specialized instruments for synovectomy
• Irrigation system
• Sutures or surgical staples

Duration

The procedure typically takes between 2 to 3 hours, depending on the extent of the surgery.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist
• Surgical assistant

Risks and Complications

• Infection at the surgical site
• Blood clots
• Bleeding
• Nerve or blood vessel damage
• Adverse reactions to anesthesia
• Stiffness or decreased range of motion post-surgery

Benefits

• Reduction in pain and inflammation
• Improved knee mobility and function
• Better quality of life with less impairment from joint issues

Recovery

• Patients will initially need to keep weight off the knee and use crutches or a walker.
• Pain management with prescribed medications.
• Physiotherapy to regain strength and mobility.
• Regular follow-up appointments to monitor healing.
• Full recovery may take several weeks to a few months.

Alternatives

• Conservative treatments such as medications, physical therapy, and corticosteroid injections.
• Arthroscopic synovectomy, a less invasive procedure.
• Total or partial knee replacement surgery in severe cases.

Patient Experience

During the procedure, the patient won't feel pain due to anesthesia. Post-operatively, patients may experience discomfort, swelling, and restricted movement, which are managed with pain relief and physical therapy. Gradual improvement in symptoms is expected over the recovery period.